Tuesday, July 10, 2012

The more things change, part 2

So, OK. Clearly my post on The More Things Change, about child safety issues, hit a nerve or three. The comments are limited to 4,000 characters, so in the interests of a fuller response, I'm doing a second post. I should say, everything I post here is my opinion, indeed, my musings on things I find interesting. I did not and do not espouse disobeying any safety laws.

First, regarding carseat laws, KalJ is correct that age 12 is a recommendation and not the law, at least in NC where I live (it varies by state - don't get me started on the insanity of that...). The law here is still 8 or 80 lbs. I should have verified that and not taken my coworker's (muddled) word for it. Still, even as a recommendation, yeesh... But the costs of infantilizing a tween by making them ride in a booster seat and the tradeoff in safety is a whole 'nother post for another day. 

As several of you pointed out, age (beyond some developmental point, probably in preschool) and weight are utterly irrelevant when it comes to the safety of children in car seatbelts. The relevant measure of whether a child (or adult) is adequately protected by a seat/shoulder belt is HEIGHT. Yet almost NO state carseat laws are based on height - they are based on age and weight. Lord only knows why - height is no harder to measure, and actually the easiest of the 3 for a cop who's pulled you over to estimate accurately (the cop's height being constant, they should be able to find out where the height cutoff falls on their own body, and use that as an index). I would not rail against a standard based on height, especially if it were coupled with laws requiring car makers to make seat belts adjustable to a reasonable range of pre-teen to adult heights. My paternal grandmother never topped 5 ft - should she have had to drive in a booster seat? (As an aside, I'm not sure I buy the contention that car seat belts are designed only for adult men - the seat belts in my Corolla, hardly an expensive car, are height adjustable to a range that easily fits The Nerd, who is currently 5'4", as well as my husband, who is 6'0".)

Moving on to cribs, how many deaths are too many and we have to ban something? Why do we ban a useful feature on cribs (drop sides) over 3-4 deaths a year, but we don't ban swimming pools? A quick google search finds a paper that found 675 drowning deaths in pools among 5-24 yr olds in a 4 year period. That's about 170 per year, a heck of a lot more than 3-4, a lot more families crushed when it's their kid, yet we haven't banned pools. Why not? They are purely recreational - there's no tangible"benefit" to them - they're just fun. There is, at least for some people, a benefit to drop sides on cribs. For me, that drop side on the crib was a life saver with Rapunzel, who was a hideously bad sleeper. Getting her down without waking her with the drop side down was hard enough; without it, it would have been nigh unto impossible. At what point would my own sleep deprivation have become a greater danger to her than the crib?

So, why are we so inconsistent? Why is it OK to ban cribs that cause 3-4 deaths a year and not ban pools that cause 170? I don't know the answer, and that's part of what interested me about the whole thing, though I obviously did not do a good job of conveying that in the original post.

One more thing. "You know more, you do better" sounds great, and in many situations, it makes sense. But gains in safety are not free. Sometimes, the costs (and I don't mean purely monetary) are small compared to the benefit of the decrease in risk. Take prenatal care: there are some risks associated with driving to appointments, but the gains in the health and well-being of both mother and fetus far outweigh them.

But that is not always the case. Take children on airplanes: statistics show that children under two are safer in a plane crash if they are in a carseat in their own seat than on a parent's lap. So, under the principle of "You know more, you do better" we should require parents to buy a seat for their kid and buckle them up, right? Not necessarily. Many airlines do now require this, with the consequence that as young families (not known for having a lot of disposable income) are faced with buying an extra ticket (or two), more of them are choosing to drive to their destination instead of fly. Except that driving, even in a carseat, is MUCH MUCH more dangerous than flying, even in a parent's lap. So we have, by saying we know more and should require people to do better, inadvertently caused MORE child deaths via car crashes than we have saved via plane crashes. Here, the costs exceed the benefits.

Now, both those examples are pretty easy comparisons because we're comparing apples to apples - child deaths under plan A to child deaths under plan B (whether it's prenatal care or carseats on planes). The tradeoff is, alas, not always so easy, and when it's not so easy, different people can and will in good faith come to different conclusions without any of them being wrong. Clearly, I came to a different conclusion than some of my readers. That does not make either me or them wrong - just different.

As a mother, I have to make tradeoffs about my children's safety all the time (see, for example, my post "You're Taking This Really Well!" about the girls doing horseback riding). As a risk assessor, I can't help thinking about those tradeoffs, and that's not a bad thing: I'd rather think about it and make conscious decisions, for good or bad, than depend on my unconscious intuition about risk (which is innately bad in pretty much all humans, myself included - our perceptions of risk are warped by a number of well-studied factors). And as a writer, it's likely something I will continue to muse on.

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